RMS is a very widespread metric of analyzing EMG. It was initially used to distinguish between healthy individuals and patients. Statistically significant information is shown in Table 5 below. A further analysis to distinguish between patients in the first month of their versus those towards the end of the therapy at 4+ months was conducted. Likewise the statistically significant cases are summarized and presented in Table 4.1 and shown in details in Table 4.2, 4.3, 4.4, 4.5, 4.5, 4.7, and 4.7. These detailed tables depict information about each repetition individually. The number of subjects the data was drawn from is shown as (N). The statistically significant values are reported and discussed in this section.
Table 4.1. Statistical analysis comparing healthy individuals to patients using RMS Motion Muscle Mean Healthy/ mV Mean Patients/ mV SE Healthy SE Patients p Value F statistic EFE ECU 0.021 0.104 0.028 0.025 0.037 4.836 PS ECU 0.015 0.095 0.019 0.018 0.005 9.281 PS PT 0.028 0.103 0.023 0.023 0.028 5.348 HOC PT 0.025 0.083 0.02 0.019 0.045 4.497 HOC FCU 0.031 0.215 0.056 0.054 0.026 5.635 HOC ECU 0.019 0.15 0.035 0.033 0.012 7.395 Ball FCU 0.051 0.135 0.026 0.025 0.03 5.281
Table 4.2. Statistical analysis of FCU in EFE motion within each repetition comparing healthy individuals to patients using RMS
Health Mean Std. Deviation N Flexor Carpi Ulnaris in Rep 1 Elbow Flexion Healthy .104 .153 13
Patient .126 .119 16
Total .116 .133 29
Flexor Carpi Ulnaris in Rep 1 Elbow Extension
Healthy .0721 .108 13 Patient .126 .154 16
Total .102 .136 29
Flexor Carpi Ulnaris in Rep 2 Elbow Flexion Healthy .0684 .100 13 Patient .158 .176 16
Total .118 .151 29
Flexor Carpi Ulnaris in Rep 2 Elbow Extension
Healthy .092 .131 13 Patient .113 .139 16
Total .104 .134 29
Flexor Carpi Ulnaris in Rep 3 Elbow Flexion Healthy .111 .162 13 Patient .134 .137 16
Total .124 .147 29
Flexor Carpi Ulnaris in Rep 3 Elbow Extension
Healthy .0619 .0953 13 Patient .182 .220 16
Table 4.3. Statistical analysis of ECU in PS motion within each repetition comparing healthy individuals to patients using RMS
Health Mean Std. Deviation N Extensor Carpi Ulnaris in Rep 1 in Pronation Healthy .014 .011 16
Patient .098 .116 17 Total .057 .093 33 Extensor Carpi Ulnaris in Rep 1 in Supination Healthy .017 .015 16 Patient .094 .102 17 Total .057 .083 33 Extensor Carpi Ulnaris in Rep 2 in Pronation Healthy .016 .014 16 Patient .098 .112 17 Total .058 .090 33 Extensor Carpi Ulnaris in Rep 2 in Supination Healthy .015 .014 16 Patient .092 .096 17 Total .055 .079 33 Extensor Carpi Ulnaris in Rep 3 in Pronation Healthy .014 .012 16 Patient .094 .108 17 Total .055 .087 33 Extensor Carpi Ulnaris in Rep 3 in Supination Healthy .015 .015 16 Patient .093 .097 17 Total .055 .080 33
Table 4.4. Statistical analysis of PT in PS motion within each repetition comparing healthy individuals to patients using RMS
Health Mean Std. Deviation N Pronator Teres in Rep 1 Pronation Healthy .046 .046 16
Patient .118 .143 17
Total .083 .112 33
Pronator Teres in Rep 1 Supination Healthy .021 .019 16 Patient .078 .119 17
Total .050 .090 33
Pronator Teres in Rep 2 Pronation Healthy .029 .024 16 Patient .129 .151 17
Pronator Teres in Rep 2 Supination Healthy .019 .019 16 Patient .078 .122 17
Total .049 .092 33
Pronator Teres in Rep 3 Pronation Healthy .033 .030 16 Patient .129 .149 17
Total .082 .118 33
Pronator Teres in Rep 3 Supination Healthy .018 .014 16 Patient .085 .133 17
Total .052 .100 33
Table 4.5. Statistical analysis of PT in HOC motion within each repetition comparing healthy individuals to patients using RMS
Health Mean Std. Deviation N Pronator Teres in Rep1 in Hand Open Healthy .026 .032 12
Patient .084 .089 13
Total .056 .073 25
Pronator Teres in Rep 1 in Hand Close Healthy .021 .029 12 Patient .084 .096 13
Total .054 .077 25
Pronator Teres in Rep 2 in Hand Open Healthy .029 .034 12 Patient .085 .090 13
Total .058 .074 25
Pronator Teres in Rep 2 in Hand Close Healthy .021 .032 12 Patient .085 .094 13
Total .054 .077 25
Pronator Teres in Rep 3 in Hand Open Healthy .033 .036 12 Patient .082 .089 13
Total .058 .072 25
Pronator Teres in Rep 3 in Hand Close Healthy .018 .026 12 Patient .082 .092 13
Table 4.6. Statistical analysis of FCU in HOC motion within each repetition comparing healthy individuals to patients using RMS
Health Mean Std. Deviation N Flexor Carpi Ulnaris in Rep 1 in Hand Open Healthy .036 .035 12
Patient .248 .400 13 Total .146 .304 25 Flexor Carpi Ulnaris in Rep 1 in Hand Close Healthy .023 .018 12 Patient .197 .287 13 Total .113 .222 25 Flexor Carpi Ulnaris in Rep 1 in Hand Open Healthy .038 .038 12 Patient .224 .319 13 Total .134 .246 25 Flexor Carpi Ulnaris in Rep 1 in Hand Close Healthy .025 .027 12 Patient .220 .351 13 Total .126 .268 25 Flexor Carpi Ulnaris in Rep 1 in Hand Open Healthy .043 .048 12 Patient .218 .288 13 Total .134 .225 25 Flexor Carpi Ulnaris in Rep 1 in Hand Close Healthy .023 .022 12 Patient .184 .253 13 Total .107 .197 25
Table 4.7. Statistical analysis of ECU in HOC motion within each repetition comparing healthy individuals to patients using RMS
Health Mean Std. Deviation N Extensor Carpi Ulnaris in Rep 1 in Hand
Open
Healthy .020 .021 12 Patient .148 .161 13 Total .087 .132 25 Extensor Carpi Ulnaris in Rep 1 in Hand
Close
Healthy .016 .016 12 Patient .118 .143 13 Total .069 .114 25 Extensor Carpi Ulnaris in Rep 2 in Hand
Open
Healthy .024 .022 12 Patient .187 .242 13 Total .109 .191 25 Extensor Carpi Ulnaris in Rep 2 in Hand Healthy .018 .012 12
Close Patient .144 .163 13 Total .083 .132 25 Extensor Carpi Ulnaris in Rep 3 in Hand
Open
Healthy .022 .018 12 Patient .161 .176 13 Total .094 .144 25 Extensor Carpi Ulnaris in Rep 3 in Hand
Close
Healthy .017 .012 12 Patient .141 .160 13 Total .081 .130 25
Table 4.8. Statistical analysis of FCU in Ball Press motion within each repetition comparing healthy individuals to patients using RMS
Health Mean Std. Deviation N Flexor Carpi Ulnaris in Rep 1 Ball Press Healthy .084 .094 14
Patient .187 .158 15 Total .137 .139 29 Flexor Carpi Ulnaris in Rep 1 Ball Relax Healthy .028 .041 14 Patient .087 .108 15 Total .058 .086 29 Flexor Carpi Ulnaris in Rep 2 Ball Press Healthy .080 .093 14 Patient .185 .158 15 Total .134 .139 29 Flexor Carpi Ulnaris in Rep 2 Ball Relax Healthy .019 .016 14 Patient .087 .112 15 Total .054 .087 29 Flexor Carpi Ulnaris in Rep 3 Ball Press Healthy .071 .080 14 Patient .179 .165 15 Total .127 .140 29 Flexor Carpi Ulnaris in Rep 3 Ball Relax Healthy .026 .035 14 Patient .085 .108 15 Total .057 .085 29
In the elbow flexion extension motion (EFE) within the comparison of healthy individuals and patients, the RMS mean of healthy individuals across the muscles was lower than
those of the patients. However, the extensor carpi ulnaris (ECU) muscle is the only one that showed significance between subjects with respect to health 0.021 ± 0.015 vs. 0.104 ± 0.159, p = 0.037. F (1, 27) = 4.836. This is shown in Graph A in Figure 4.1. The higher RMS value in patients indicates that the muscle is being recruited with a higher demand than healthy individuals. Although the ECU is primarily a wrist moving muscle, its anatomy suggests it may play a role in elbow flexion. Due to the patients’ injuries, neuromuscular coordination may be compromised leading the body to activate other nearby muscles to achieve the same motion.
D
A
Figure 4.1 RMS means of ECU in EFE (A) motion in healthy individuals and patients with a standard deviation +/- 1
Figure 4.2 RMS means of PT in PS (B) and ECU in PS (C) motions in healthy individuals and patients with a standard deviation +/- 1
B
Figure 4.3. RMS means of PT in HOC (D) and FCU in HOC (E) motion in healthy
D
Figure 4.4. RMS means of ECU in HOC (F) and FCU in Ball Pressing (G) motion
F
In the pronation–supination motion, the healthy individuals’ means were also lower than those of the patient population. Two muscles showed statistical significance in difference between healthy individuals and the patient population. The first muscle is the PT showing healthy individuals at 0.028 ± 0.046 vs. 0.103 ± 0.142, p = 0.028, F (1,31) = 5.348 (Graph B in Figure 4.2). The second muscle is the ECU showing healthy
individuals at 0.015 ± 0.011 vs. 0.095 ± 0.1155, p = 0.005. F (1,31) = 9.281 (Graph C in Figure 4.2). As displayed in graph B in Figure 4.2, the PT is activated at a higher
magnitude in patients than healthy individuals despite being the correct muscle to be activated in pronation. Due to the injuries and possible muscle atrophy, the body recruits a higher number of motor units to achieve the same motion as the healthy population. The ECU is not a primary mover in pronation and supination, however this muscle was over active in the patient population. Again, since the neuromuscular control may be compromised in the patients, over activation of non-required muscles is possible.
In the wrist flexion–extension motion, the mean of healthy individuals is lower than that of the patient average. However, none of the muscles showed statistical significance within this motion. Similarly, in the ulnar–radial deviation motion, the mean of healthy individuals is lower than that of the patient average. However, none of the muscles showed statistical significance within this motion. For further details, please see Table C.5 in Appendix C.
Just like the previous motion, the hand open–close motion also showed a general trend in the mean showing healthy individuals lower than the patient population. Conversely, in this motion, three muscles showed statistical significance. The first muscle was the PT with a healthy mean of 0.025 ± 0.032 vs. 0.083 ± 0.089, p = 0.045, F (1,23) =4.497 (Graph D in Figure 4.3). Secondly, the FCU showed a healthy mean of 0.031 ± 0.035 vs. 0.215 ± 0.40, p = 0.026, F (1,23) =5.635 (Graph E in Figure 4.3). Lastly, the ECU portrayed a healthy mean of 0.019 ± 0.021 vs. 0.15 ± 0.16, p = 0.012, F (1,23) =7.395, 1 degree (Graph F in Figure 4.4).
The electrodes were directly placed on the muscles responsible for moving the fingers. Nevertheless, the forearm muscles are very tightly packed; therefore, the electrodes close to these muscles may have picked them up leading to the statistical significant differences obtained. The PT and the FCU are both near the flexor digitorum profundus, flexor digitorum superficialis, and palmaris longus, which are all flexors of the fingers.
Furthermore, the ECU is near the extensor digitorum muscle, which is responsible for extending the fingers. This could explain the differences in these muscles in the HOC motion.
Likewise, the ball pressing motion exhibited a general lower mean trend in healthy individuals compared to the patient population. This was only statistically significant in the FCU with a healthy mean of 0.051 ± 0.09 vs. 0.135 ± 0.156, p = 0.03, F (1,27) =5.281 (Graph G in Figure 4.4).
Next, the second type of analysis between early and late stage patients is reported and discussed (see Table 4.9, 4.10, 4.11, 4.12, 4.13, 4.14, 4.15, 4.16, 4.17, 4.18, 4.19, 4.20, and 4.21). A higher number of statistical significances were observed in this type of analysis.
Table 4.9. Pairwise comparison between patients at 0–1 months of injury and 4+ months of injury using RMS
Motion Muscle Mean 0–1 Month Mean 4+ Months SE 0–1 Month SE 4+ Months Sig EFE TB 1.35 0.4 0.28 0.19 0.01 EFE TB2 5.29 0.34 1.46 0.96 0.01 WFE TB 0.90 0.11 0.19 0.10 0.002 PS TB 0.86 0.14 0.24 0.14 0.014 PS PT 0.05 0.20 0.06 0.03 0.04 URD TB 5.38 0.12 1.59 1.42 0.022 URD TB2 4.27 0.09 1.50 1.34 0.049 HOC BB 0.25 0.08 0.06 0.04 0.035 HOC TB 4.20 0.11 1.00 0.65 0.003 HOC TB2 4.26 0.08 1.30 0.86 0.015 Ball TB2 4.42 0.39 1.24 1.24 0.031 Ball FCU 0.34 0.06 0.04 0.037 0.000026 Ball ECU 0.02 0.44 0.13 0.13 0.032
Table 4.10. Pairwise comparison of TB in EFE motion between patients at 0–1 months of injury and 4+ months of injury using RMS
Health Mean Std. Deviation N Triceps Long in Rep 1 in Elbow Flexion Healthy .274 .297 13
4+ months .201 .108 6 0-1 months 2.912 2.897 3 Triceps Long in Rep 1 in Elbow Extension Healthy .247 .213 13 4+ months .155 .096 6 0-1 months 1.062 1.222 3 Triceps Long in Rep 2 in Elbow Flexion Healthy .250 .255 13 4+ months .192 .089 6 0-1 months 1.094 1.382 3 Triceps Long in Rep 2 in Elbow Extension Healthy .214 .227 13 4+ months .164 .092 6 0-1 months 1.051 1.199 3 Triceps Long in Rep 3 in Elbow Flexion Healthy .279 .309 13 4+ months .204 .105 6 0-1 months 1.067 1.327 3 Triceps Long in Rep 3 in Elbow Extension Healthy .162 .084 13 4+ months .122 .063 6 0-1 months .936 .824 3
Table 4.11. Pairwise comparison of TB2 in EFE motion between patients at 0–1 months of injury and 4+ months of injury using RMS
Health Mean Std. Deviation N Triceps Lateral in Rep 1 in Elbow Flexion Healthy .055 .060 13
4+ months .366 .382 6 0-1 months 5.270 8.880 3 Triceps Lateral in Rep 1 in Elbow
Extension
Healthy .069 .058 13 4+ months .403 .382 6 0-1 months 5.199 8.760 3 Triceps Lateral in Rep 2 in Elbow Flexion Healthy .045 .038 13 4+ months .394 .389 6 0-1 months 5.282 8.906 3 Triceps Lateral in Rep 2 in Elbow
Extension
Healthy .052 .041 13 4+ months .370 .401 6
0-1 months 5.361 9.059 3 Triceps Lateral in Rep 3 in Elbow Flexion Healthy .072 .080 13 4+ months .427 .384 6 0-1 months 5.296 8.928 3 Triceps Lateral in Rep 3 in Elbow
Extension
Healthy .066 .074 13 4+ months .358 .397 6 0-1 months 5.358 9.107 3
Table 4.12. Pairwise comparison of TB2 in WFE motion between patients at 0–1 months of injury and 4+ months of injury using RMS
Health Mean Std. Deviation N Triceps Long in Rep 1 in Wrist Flexion Healthy .091 .117 13
4+ Months .103 .0867 7 0-1 Months 1.01 1.245 2 Triceps Long in Rep 1 in Wrist Extension Healthy .092 .115 13 4+ Months .106 .0815 7 0-1 Months .992 1.234 2 Triceps Long in Rep 2 in Wrist Flexion Healthy .095 .116 13 4+ Months .109 .091 7 0-1 Months 1.006 1.23 2 Triceps Long in Rep 2 in Wrist Extension Healthy .092 .114 13 4+ Months .108 .0881 7 0-1 Months .992 1.223 2 Triceps Long in Rep 3 in Wrist Flexion Healthy .096 .115 13 4+ Months .116 .101 7 0-1 Months .995 1.204 2 Triceps Long in Rep 3 in Wrist Extension Healthy .085 .068 13 4+ Months .092 .073 7 0-1 Months .407 .490 2
Table 4.13. Pairwise comparison of TB in PS motion between patients at 0–1 months of injury and 4+ months of injury using RMS
Health Mean Std. Deviation N Triceps Long in Rep 1 in Pronation Healthy .198 .517 16
4+ Months .127 .070 6 0-1 Months .955 1.252 2 Triceps Long in Rep 1 in Supination Healthy .133 .258 16 4+ Months .122 .044 6 0-1 Months .950 1.216 2 Triceps Long in Rep 2 in Pronation Healthy .126 .242 16 4+ Months .157 .051 6 0-1 Months .945 1.237 2 Triceps Long in Rep 2 in Supination Healthy .130 .241 16 4+ Months .137 .057 6 0-1 Months .945 1.237 2 Triceps Long in Rep 3 in Pronation Healthy .129 .244 16 4+ Months .152 .064 6 0-1 Months .950 1.245 2 Triceps Long in Rep 3 in Supination Healthy .089 .122 16 4+ Months .103 .057 6 0-1 Months .420 .481 2 Table 4.14. Pairwise comparison of PT in PS motion between patients at 0–1 months of injury and 4+ months of injury using RMS
Health Mean Std. Deviation N Pronator Teres in Rep 1 in Pronation Healthy .046 .046 16
4+ Months .230 .191 6 0-1 Months .050 .028 2 Pronator Teres in Rep 1 in Supination Healthy .021 .019 16 4+ Months .165 .174 6 0-1 Months .035 .007 2 Pronator Teres in Rep 2 in Pronation Healthy .029 .024 16 4+ Months .240 .207 6 0-1 Months .060 .014 2 Pronator Teres in Rep 2 in Supination Healthy .019 .019 16 4+ Months .158 .186 6 0-1 Months .040 .014 2
Pronator Teres in Rep 3 in Pronation Healthy .033 .030 16 4+ Months .238 .210 6 0-1 Months .065 .007 2
Total .086 .123 30
Pronator Teres in Rep 3 in Supination Healthy .018 .014 16 4+ Months .173 .203 6 0-1 Months .050 .014 2
Table 4.15. Pairwise comparison of TB in URD motion between patients at 0–1 months of injury and 4+ months of injury using RMS
Health Mean Std. Deviation N Triceps Long in Rep 1 in Ulnar Deviation Healthy .104 .129 13
4+ Months .128 .100 5 0-1 Months 6.243 10.387 4 Triceps Long in Rep 1 in Radial Deviation Healthy .102 .124 13 4+ Months .130 .101 5 0-1 Months 5.850 9.533 4 Triceps Long in Rep 2 in Ulnar Deviation Healthy .105 .128 13 4+ Months .130 .109 5 0-1 Months 6.295 10.453 4 Triceps Long in Rep 2 in Radial Deviation Healthy .104 .125 13 4+ Months .130 .107 5 0-1 Months 6.128 10.088 4 Triceps Long in Rep 3 in Ulnar Deviation Healthy .105 .129 13 4+ Months .128 .0971 5 0-1 Months 6.255 10.356 4 Triceps Long in Rep 3 in Radial Deviation Healthy .0831 .0616 13 4+ Months .0920 .0577 5 0-1 Months 1.490 2.043 4 Table 4.16. Pairwise comparison of TB2 in URD motion between patients at 0–1 months of injury and 4+ months of injury using RMS
Health Mean Std. Deviation N Triceps Lateral in Rep 1 in Ulnar
Deviation
Healthy .029 .035 13 4+ Months .082 .091 5 0-1 Months 4.285 8.324 4
Triceps Lateral in Rep 1 in Radial Deviation
Healthy .028 .035 13 4+ Months .068 .086 5 0-1 Months 4.245 8.251 4 Triceps Lateral in Rep 2 in Ulnar
Deviation
Healthy .030 .037 13 4+ Months .098 .093 5 0-1 Months 4.258 8.269 4 Triceps Lateral in Rep 2 in Radial
Deviation
Healthy .029 .036 13 4+ Months .100 .089 5 0-1 Months 4.290 8.334 4 Triceps Lateral in Rep 3 in Ulnar
Deviation
Healthy .029 .038 13 4+ Months .104 .105 5 0-1 Months 4.285 8.337 4 Triceps Lateral in Rep 3 in Radial
Deviation
Healthy .030 .040 13 4+ Months .078 .091 5 0-1 Months 4.248 8.262 4 Table 4.17. Pairwise comparison of BB in HOC motion between patients at 0–1 months of injury and 4+ months of injury using RMS
Health Mean Std. Deviation N Biceps in Rep 1 in Hand Open Healthy .085 .089 12
4+ Months .093 .066 7 0-1 Months .253 .202 3 Biceps in Rep 1 in Hand Close Healthy .083 .089 12 4+ Months .084 .055 7 0-1 Months .250 .203 3 Biceps in Rep 2 in Hand Open Healthy .088 .088 12 4+ Months .093 .065 7 0-1 Months .253 .202 3 Biceps in Rep 2 in Hand Close Healthy .084 .089 12 4+ Months .087 .064 7 0-1 Months .260 .207 3 Biceps in Rep 3 in Hand Open Healthy .086 .089 12 4+ Months .093 .064 7 0-1 Months .253 .202 3 Biceps in Rep 3 in Hand Close Healthy .083 .087 12 4+ Months .086 .054 7 0-1 Months .250 .207 3
Table 4.18. Pairwise comparison of TB in HOC motion between patients at 0–1 months of injury and 4+ months of injury using RMS
Health Mean Std. Deviation N Triceps Long in Rep 1 in Hand Open Healthy .124 .141 12
4+ Months .123 .164 7 0-1 Months 4.843 6.376 3 Triceps Long in Rep 1 in Hand Close Healthy .121 .142 12 4+ Months .119 .162 7 0-1 Months 4.883 6.444 3 Triceps Long in Rep 2 in Hand Open Healthy .128 .142 12 4+ Months .126 .159 7 0-1 Months 4.877 6.441 3 Triceps Long in Rep 2 in Hand Close Healthy .123 .144 12 4+ Months .121 .170 7 0-1 Months 4.467 5.721 3 Triceps Long in Rep 3 in Hand Open Healthy .128 .147 12 4+ Months .120 .166 7 0-1 Months 4.917 6.453 3 Triceps Long in Rep 3 in Hand Close Healthy .094 .062 12 4+ Months .071 .048 7 0-1 Months 1.227 1.320 3
Table 4.19. Pairwise comparison of TB2 in HOC motion between patients at 0–1 months of injury and 4+ months of injury using RMS
Health Mean Std. Deviation N Triceps Lateral in Rep 1 in Hand Open Healthy .051 .092 12
4+ Months .067 .061 7 0-1 Months 4.267 7.182 3 Triceps Lateral in Rep 3 in Hand Close Healthy .049 .090 12 4+ Months .069 .062 7 0-1 Months 4.277 7.200 3 Triceps Lateral in Rep 1 in Hand Open Healthy .051 .092 12 4+ Months .084 .062 7 0-1 Months 4.257 7.174 3 Triceps Lateral in Rep 3 in Hand Close Healthy .051 .093 12 4+ Months .071 .061 7
0-1 Months 4.270 7.188 3 Triceps Lateral in Rep 1 in Hand Open Healthy .051 .095 12 4+ Months .087 .064 7 0-1 Months 4.250 7.153 3 Triceps Lateral in Rep 3 in Hand Close Healthy .058 .115 12 4+ Months .080 .069 7 0-1 Months 4.257 7.165 3
Table 4.20. Pairwise comparison of TB2 in Ball Press motion between patients at 0–1 months of injury and 4+ months of injury using RMS
Health Mean Std. Deviation N Triceps Lateral in Rep 1 in Ball Press Healthy .269 .204 14
4+ Months .693 .501 3 0-1 Months 4.427 7.373 3 Triceps Lateral in Rep 1 in Ball Relax Healthy .118 .142 14 4+ Months .437 .562 3 0-1 Months 4.417 7.555 3 Triceps Lateral in Rep 2 in Ball Press Healthy .306 .210 14 4+ Months .373 .309 3 0-1 Months 4.427 7.391 3 Triceps Lateral in Rep 2 in Ball Relax Healthy .091 .123 14 4+ Months .090 .089 3 0-1 Months 4.447 7.607 3 Triceps Lateral in Rep 3 in Ball Press Healthy .298 .208 14 4+ Months .650 .372 3 0-1 Months 4.460 7.431 3 Triceps Lateral in Rep 3 in Ball Relax Healthy .096 .131 14 4+ Months .083 .085 3 0-1 Months 4.317 7.347 3 Table 4.21. Pairwise comparison of FCU in Ball Press motion between patients at 0–1 months of injury and 4+ months of injury using RMS
Health Mean Std. Deviation N Flexor Carpi Ulnaris in Rep 1 in Ball
Press
Healthy .084 .094 14 4+ Months .087 .058 3 0-1 Months .413 .140 3
Flexor Carpi Ulnaris in Rep 1 in Ball Relax
Healthy .028 .041 14 4+ Months .027 .006 3 0-1 Months .253 .133 3 Flexor Carpi Ulnaris in Rep 2 in Ball
Press
Healthy .080 .093 14 4+ Months .117 .085 3 0-1 Months .420 .165 3 Flexor Carpi Ulnaris in Rep 2 in Ball
Relax
Healthy .019 .016 14 4+ Months .030 .010 3 0-1 Months .260 .140 3 Flexor Carpi Ulnaris in Rep 3 in Ball
Press
Healthy .071 .080 14 4+ Months .093 .064 3 0-1 Months .427 .176 3 Flexor Carpi Ulnaris in Rep 3 in Ball
Relax
Healthy .026 .035 14 4+ Months .030 .010 3 0-1 Months .237 .165 3 Table 4.22. Pairwise comparison of ECU in Ball Press motion between patients at 0–1 months of injury and 4+ months of injury using RMS
Health Mean Std. Deviation N Extensor Carpi Ulnaris in Rep 1 in Ball
Press
Healthy .026 .030 14 4+ Months .433 .632 3 0-1 Months .023 .006 3 Extensor Carpi Ulnaris in Rep 1 in Ball
Relax
Healthy .016 .014 14 4+ Months .410 .608 3 0-1 Months .017 .006 3 Extensor Carpi Ulnaris in Rep 2 in Ball
Press
Healthy .025 .026 14 4+ Months .453 .667 3 0-1 Months .020 .000 3 Extensor Carpi Ulnaris in Rep 2 in Ball
Relax
Healthy .015 .014 14 4+ Months .420 .626 3 0-1 Months .020 .010 3 Extensor Carpi Ulnaris in Rep 3 in Ball
Press
Healthy .026 .029 14 4+ Months .463 .692 3 0-1 Months .023 .006 3 Extensor Carpi Ulnaris in Rep 3 in Ball
Relax
Healthy .014 .011 14 4+ Months .430 .659 3 0-1 Months .027 .012 3
Both long and lateral heads of the triceps had a higher mean in the EFE movement in patients at their first month of therapy compared to patients in their 4th month 0.35 ± 2.9 vs. 0.4 ± 0.85, p = 0.01 (see Graphs A and B in Figures 4.5 and 4.6) This shows that healthier individuals tend to depend more on gravity to obtain elbow extension while patients have to actively contract their triceps at a great extent to obtain the movement required. In wrist flexion and extension, the long head of the triceps also exhibited higher activation levels in the 0–1 month rehabilitation population 0.90 ± 0.09 vs. 0.11±1.24, p
= 0.002 (Graph C in Figure 4.6). The long head is responsible for extending the elbow and adducting the shoulder. The injury may cause the patients to actively stimulate the muscle in order to keep the arm stable at a 90-degree angle when they are performing the wrist motions. Moreover, subjects were asked to keep their arm to their side at all times. This could be effortless for healthy individuals, while patients with fresh injuries have uncoordinated neuromuscular control leading to the over-activation observed. Similarly, in the pronation and supination motion, the long head of the triceps showed almost the same mean difference as shown in the wrist flexion–extension motion with a 0–1 month mean of 0.86 ± 0.07 vs. 0.14 ± 1.25, p = 0.014 (Graph D in Figure 4.7). Again, this could be related to stabilizing the elbow at 90 degrees and keeping the arm close to the body. In contrast, the PT displayed a higher mean in patients towards the end of their therapy compared to those in the beginning 0.05 ± 0.03 vs. 0.20 ± 0.19, p = 0.04 (Graph E in Figure 4.7). This finding does not align with the trend of higher means in first-month patients. Nevertheless, it could be explained by the incapability of contracting the muscle by patients, and therefore, it does not show high levels of activation.
Again, in the URD (Graphs F and G in Figure 4.8) and HOC (Graph H and I in Figure 4.9) movement, both TB and TB2 in URD showed statistical differences of 5.38 ± 0.1 vs. 1.59 ± 0.051, p = 0.022 and4.27 ± 0.09 vs. 1.50 ± 8.2, p = 0.49 respectively. They could be explained by the previous explanations in WFE and PS. In addition to the TB and TB2 showing differences in HOC (Graphs J and K in Figure 4.10), 4.2 ± 0.1 vs. 1.00 ± 0.016, p = 0.003 and 4.26 ± 7.18 vs. 0.08 ± 0.06, p = 0.015, the biceps showed a higher mean in 0–1 month patients versus the 4+ months patients 0.25 ± 0.11 vs. 0.08 ± 0.06, p
= 0.022 (Graph I in Figure 4.9). The biceps should be activated enough to stabilize the elbow in place, however it seemed to activate even when the 0–1 months individuals
closed their hand. This is another example showing neuromuscular control being compromised enough to cause inappropriate activations of muscles.
In the ball pressing motion, 3 muscles showed significant differences. Firstly, the lateral head of the triceps showed a mean of 4.42 ± 0.5 vs. 0.39 ± 7.37, p = 0.031 (Graph L in Figure 4.11). The activation of this muscle is normal in this case, as the motion requires elbow extension. The higher magnitude of activation in the 0–1 patient group is the common trend and therefore aligns with the findings previously mentioned in this thesis explaining that injured people may require higher activation to achieve the same output as healthier individuals. Next, the FCU also showed a much greater mean then the late